The Problem With the Healthcare Debate

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With all the debate going on in the US about ‘Obamacare’ and health reform it is hard for Americans to not make comparisons to other systems. The Canadian system has been used as an example by both the GOP and the Dems as an example of what we shouldn’t or should do. Naturally, as a Canadian I am willing to blindly defend our health-care are being the best in the world; after all, that’s what our politicians have been telling us for eons, right?

Today, the Conference Board of Canada released a report ranking the health-care outcomes of 16 developed countries. Of course, the US received a D came last (but we expected that, it was written by a Canadian group after all). Canada received a B and came 10th out of the 16 while the US received a D and 16th. Those damn Europeans always seem to beat us out. Gasp! Say it ain’t so!

Our egos were stroked enough by beating the US so handily that we failed to see what the report was truly trying to tell us. Go back and read what the rankings were looking at again. They were looking at health-care outcomes not systems. Obama and Congress are trying to find the ‘best’ system, not the ‘best American system’. The terms of the US debate on health-care centre around how much the Feds should be involved in the health-care system (a public/private debate) instead of focusing on the real issue: How can we make more Americans healthier? If the debate was refocused, some tangible results would likely result.

Rankings

Rising rates of diabetes are a great place to start. Canada and the US came 14th and 15th respectively on mortality due to diabetes. Japan came out on top. I’m going to go out on a limb and say that the differences in diabetes mortality rates between the three countries isn’t a result of different health-care systems (Canada and the US have dramatically different systems and come in right next to each other). It is more likely a result of the differences in overall lifestyle. Over several decades Japan has encouraged a culture of activity in its society. We’ve all seen videos of crazy Japanese companies leading afternoon exercises with all of their employees.

This culture seemed to have worked. A 2003 OECD report shows that 24.9% of Japanese are overweight (BMI>25kg/m) and only 3.2% are obese (BMI>30kg/m). Compare that to the US where 65.7% are overweight and 30.6% are obese and the problem is clear. Americans are fat and Japanese aren’t. It isn’t a genetic thing either, Japan gave us sumo wrestling remember.

Whats wrong with being fat? It leads to Type 2 diabetes for one. 95% of people suffering from diabetes are Type 2 ‘adult onset’ diabetics. Increases in these diabetics can be attributed to “aging population, rising obesity rates, increasingly sedentary lifestyles, and higher risk for diabetes for Aboriginal people” (source). It no wonder then that as we (Canadians and Americas) are getting fatter, we get less healthy.

Second, diabetics are expensive.

  • People with diabetes incur medical costs that are two to three times higher than those without diabetes. A person with diabetes can face direct costs for medication and supplies ranging from $1,000 to $15,000 a year.
  • By 2010, it’s estimated that diabetes will cost the Canadian health-care system $15.6 billion a year and that number will rise to $19.2 billion by 2020.

Its no wonder that the Canadian system is running short on cash or American insurers charge exorbitant premiums. Fat people make health care expensive for all of us.

Despite this, all of the talk in the US around health-care reform has centered around a ‘public option’. Why not drop the ideological part of the battle (which is the causing the deadlock) and find easy ways to make American’s healthier. Building more community centres where people can work out, aiding youth athletics programs, and helping at risk kids get into sports for life. It can’t stop there though, staying active throughout your whole life will make you healthier, is free (or nearly free), and will make your government/insurer happy.

It isn’t hard to start either:

In a large study, people at risk of type 2 diabetes were able to reduce that risk by 58% by exercising moderately for 30 minutes a day and by losing 5 to 7% of their body weight. In people over age 60, the risk was cut by almost 71%. Other large studies have shown similar results in reducing risk. (Source)

Besides which, I’d much prefer to see Obama pump money into programs that directly affect change in the US than fill the pockets of an inevitably inefficient bureaucracy.

With all the money he’ll save we can afford some extra twinkies apples. One of them a day could keep a public health-care battle at bay.

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Geoff is a 5th year student who studying a double major in Integrated Science (Evolutionary ecology, virology) and Political Science. He was the 'Wish' speaker at the 2008 Terry Talks and is passionate about university education, especially when it comes to interdisciplinary experiences. After graduation Geoff wants to find a job that allows him to meet people from all sorts of backgrounds and share stories. If your savvy enough you can follow Geoff on Twitter - user: gcosteloe.

2 Responses to “The Problem With the Healthcare Debate”

  1. Nicholas FitzGerald

    (repost of my comment on your blog)

    If overall health outcomes were the only consideration you might have a point, but there’s more to it than that. 18 percent of Americans under 65 have NO HEALTH INSURANCE. That means if they break their arm they have to choose between getting that treated or paying rent next month. Cultural influences on health outcomes aside, no one should have to make that choice.

    As for the popular conservative bogeyman, it’s amazing to me how often we are told to fear the “inevitably inefficient bureaucracy” without this ever being substantiated by fact. Total public and private expenditure per capita on healthcare is double in America what it is in Canada or Great Britain. No matter how many times conservatives and libertarians trot out the supposed efficiency of the all-powerful free market, doesn’t make it any more true in reality.

  2. Ian McDonald

    I have to completely agree with Nicholas here. Outcomes are not the only consideration, the ability to get treatment and not have to skip meals or rent should be considered a human right.

    I also have to take issue with your comparison with Japan. Two things to consider; diet, and corporate culture. Japanese businesses conduct these exercises to build team morale, and to ensure that the businessmen are being compliant, not out of any particular sense for the well-being of the worker (although a healthy worker is an efficient worker). Secondly, and much more important, is the Japanese diet. This is the primary reason that Japanese obesity rates are so low. They eat very little fast food, have a diet high in vegetables and fish, and consume much less red meat than the “average” American.

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